A growing pattern of automated E/M reductions is appearing across multiple states, and most practices won’t see the losses until the month-end numbers don’t add up. Your E/M payments may already be shifting.
When Cigna Healthcare's R49 policy made headlines in October 2025, many assumed it was an isolated case. Cigna Healthcare then paused the policy due to regulatory pressure. The relief was short-lived. The trend didn't stop; it had already spread to nearly every major insurer in the country.
Oct 166 min read
In fact, one healthcare provider we worked with achieved 132% of monthly collection goals.
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✓ Hidden revenue leaks in your payer contracts
✓ Downcoding exposure you might not see
✓ Early warning signs of contract breakdown
